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从泌尿科医生的角度来看:我们在内镜手术中安全吗?泌尿科医生在视频内镜手术中遇到的人体工程学问题概述。

From an urologist view: are we safe with endoscopic surgery? Overview of ergonomic problems encountered by the urologist during video endoscopic surgery.

作者信息

Sataa Sallami, Benzarti Aida, Ben Jemaa Abdelmajid

机构信息

Department of Urology, La Rabta Hospital-University, Faculty of Medicine of Tunis, University of Tunis - El Manar, Tunisia.

出版信息

Tunis Med. 2012 Dec;90(12):843-6.

Abstract

BACKGROUND

The importance of minimally invasive surgery in urology has constantly increased in the last 20 years. Endoscopic resection of prostate and bladder tumors is actually a gold standard with many advantages for patients.

AIM

To analyze the problems related to the ergonomic conditions faced by urologist during video endoscopic surgery by review of the recent literature.

METHODS

All evidence-based experimental ergonomic studies conducted in the fields of urology endoscopic surgery and applied ergonomics for other professions working with a display were identified by PubMed searches. Data from ergonomic studies were evaluated in terms of efficiency as well as comfort and safety aspects. Constraint postures for urologists are described and ergonomic requirements for optimal positions are discussed.

RESULTS

The ergonomics of urological endoscopic surgery place urologists at risk for potential injury. The amount of neck flexion or extension, the amount of shoulder girdle adduction or abduction used, and stability of the upper extremities during surgery; which are maintained in a prolonged static posture; are the main risk factors. All these constraints may lead to muscle and joint fatigue, pain, and eventual musculoskeletal injury. Moreover, these issues may impact surgical accuracy.

CONCLUSION

Urologist posture, operating period, training are important ergonomic factor during video surgery to prevent musculoskeletal disorders.

摘要

背景

在过去20年里,泌尿外科微创手术的重要性一直在不断提高。前列腺和膀胱肿瘤的内镜切除术实际上是一种金标准,对患者有诸多益处。

目的

通过回顾近期文献,分析泌尿外科医生在视频内镜手术中面临的人体工程学相关问题。

方法

通过PubMed检索,确定在泌尿外科内镜手术领域进行的所有基于证据的实验性人体工程学研究,以及应用于其他使用显示器工作职业的人体工程学研究。从效率以及舒适性和安全性方面对人体工程学研究数据进行评估。描述了泌尿外科医生的受限姿势,并讨论了最佳姿势的人体工程学要求。

结果

泌尿外科内镜手术的人体工程学使泌尿外科医生面临潜在受伤风险。手术过程中颈部屈伸的程度、肩带内收或外展的程度以及上肢的稳定性;这些都保持在长时间的静态姿势;是主要风险因素。所有这些限制都可能导致肌肉和关节疲劳、疼痛,最终导致肌肉骨骼损伤。此外,这些问题可能会影响手术准确性。

结论

泌尿外科医生的姿势、手术时间、培训是视频手术中预防肌肉骨骼疾病的重要人体工程学因素。

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